An evaluation of suloctidil in the prevention of deep vein thrombosis in neurosurgical patients.

Suloctidil (200 mg t.i.d.) was compared with placebo in a randomized, double-blind trial to assess its value in preventing deep venous thrombosis (DVT) in high-risk neurosurgical patients, comprising 136 patients with brain or spinal tumour, head or spinal injury, or subarachnoid or intracranial hemorrhage. 125I fibrinogen leg scanning and impedance plethysmography were performed for up to 14 days to detect DVT. The two groups were also evenly balanced for DVT risk factors. Seventeen of 68 patients (25%) (95% confidence interval, 15-35%) treated with suloctidil and 12 of 68 patients (21%) (95% confidence interval, 11-32%) treated with placebo developed deep venous thrombosis. This observed difference in outcomes is not statistically significant (X2 = 1.096; p = 0.30). The estimated 95% confidence interval for the true difference in the incidence of DVT between suloctidil-treated and placebo-treated patients ranges from an 11% benefit in favour of suloctidil to an 18% benefit in favour of placebo. Major deep vein thrombosis occurred in two patients on suloctidil and three patients in the placebo group; there were no fatal pulmonary emboli during the 14-day study period, during which time four patients in each group died of non-thromboembolic complications. There was no observed difference in hemorrhagic complications. Long-term outcomes at three-months follow-up were similar between the two treatment groups. It is concluded that there is no real evidence that suloctidil (200 mg t.i.d.) is an effective regimen for the prevention of DVT in high-risk neurosurgical patients.

Effect of suloctidil on platelet function in patients with shortened platelet survival time.

The effect of suloctidil (600 mg/day) on platelet survival time (PST) and plasma and urine betathromboglobulin (BTG) was studied in a double-blind, placebo-controlled six-week crossover trial in 13 patients with shortened PST (less than 110 hrs, exponential model). Mean PST after suloctidil (110.6 hrs) was significantly higher than in the placebo phase (94.5 hrs) (p = 0.04). Mean plasma BTG was significantly lower during the suloctidil phase (42.8 ng/ml) compared with the placebo phase (65.8 ng/ml) (p = 0.02), but there was no significant difference in urine BTG. These results suggest that suloctidil provides a platelet protective effect and therefore may be of benefit in reducing the frequency of platelet mediated thromboembolic events.

Activity of three new rifamycin derivates on the experimental infection by Mycobacterium leprae

Three new rifamycin derivates characterized by longer lasting were tested M. leprae in the mouse model. Their minimal effective dose is slightly to moderately lower than that of rifampicin. Intervals of administration can however not be increased over once every 2 weeks. On a weght basis one of the drugs is 8 times more potent than rifampicin.

Minimal inhibitory dosage of rifampicin in intermittent treatment of Mycobacterium leprae infection in mice.

The total minimal inhibitory dose of rifampicin determined in the experimental mouse model, was found to be 10 mg/kg body weight, administered once a week for 6 weeks or once every 2 weeks for 12 weeks. From these and other results it is suggested that administration of RMP in human treatment can be reduced to a total amount of 7.2 either as a 600 mg dose once a week for 12 weeks or as a 900 mg dose once a week for 8 weeks. At present these regimens can only be used as an introductory treatment for multibacillary cases and are still too expensive for developing countries, but their efficacy should be evaluated in the field as sole treatments in tuberculoid cases, since they could signify a substantial economy for the management of the majority of leprosy infections.